YATARAK REHABİLİTASYON UYGULANAN KRONİK SPİNAL KORD YARALANMALI HASTALARDA YARALANMA BÖLGESİ VE YARALANMA ŞİDDETİ HASTA MEMNUNİYETİNİ ETKİLER Mİ ?

Öz

AMAÇ: Bu çalışmanın amacı yatarak rehabilitasyon tedavisi alan kronik spinal kord yaralanmalı (SKY) hastaların memnuniyet düzeylerinin, yaralanma seviyesi ve şiddetine göre farklılık gösterip göstermediğini incelemek ve farklı memnuniyet düzeyine sahip hastaların fonksiyonel bağımsızlık ve yaşam kaliteleri arasında fark olup olmadığını ortaya koymaktır.
GEREÇ VE YÖNTEM: Hastaların lezyon seviyesi (servikal, torasik, lumbosakral) kaydedildi ve lezyonun şiddeti (komplet/inkomplet) American Spinal Cord Injury Association (ASIA) Impairment Scale'e göre belirlendi. Hastaların bağımsızlık derecesi, Fonksiyonel Bağımsızlık Ölçümü (Functional Independence Measure-FİM) motor skoru kullanılarak belirlendi. Sağlıkla ilişkili yaşam kalitesi değerlendirilmesi için kısa form-36 (Short Form-36- SF-36) kullanıldı. Memnuniyet, hasta memnuniyetini değerlendirmek için oluşturulmuş bir anket kullanılarak değerlendirildi. Ankette memnuniyet düzeyi “çok memnunum, memnunum, memnuniyetsizim, hiç memnun değilim” olarak ve doktor, hemşire, fizyoterapist, yemek hizmeti, temizlik hizmeti, teknik donanım ve genel memnuniyet kategorilerinde sorgulama yapılarak belirlendi.
BULGULAR: Bu kesitsel çalışmaya kronik SKY'li 84 hasta dahil edildi. Lezyon seviyesine göre bakıldığında, hastaların 19’unda servikal (ortalama yaş: 36.3 ± 14.5, % 78.9 erkek), 52’sinde torasik (ortalama yaş: 32.1 ± 13.6, % 61.5 erkek) ve 13’ünde lumbosakral (ortalama yaş : 38.8 ± 20, % 61.5 erkek) yaralanma bulunmaktaydı. SKY'nin şiddetine göre 36 hastada komplet (ortalama yaş: 34 ± 13, % 77.7 erkek), 48 hastada inkomplet (ortalama yaş: 35 ± 15, % 56.2 erkek) yaralanma vardı. Memnuniyet kategorilerinde servikal, torasik ve lumbosakral bölge yaralanmaları arasında anlamlı fark bulunmadı. Ancak, SKY şiddetine göre gruplandırılan hastaların memnuniyetleri karşılaştırıldığında, inkomplet SKY'li hastaların doktor ve teknik donanım memnuniyetleri daha yüksekti (sırasıyla p=0.03 ve p=0.02). Bunun dışında diğer kategorilerde anlamlı fark bulunamadı. Genel memnuniyet kategorisinde, memnuniyet düzeylerine göre gruplandırılan hastaların fonksiyonel motor bağımsızlıkları ve yaşam kaliteleri karşılaştırıldığında arada anlamlı fark bulunamadı.
SONUÇ: İnkomplet SKY’li hastaların doktor ve teknik donanım memnuniyeti daha yüksekti. Yaralanma özellikleri farklı olsa da beklentileri karşılandığında, yatarak rehabilitasyon uygulanan kronik dönem SKY’li hastaların memnuniyet düzeyleri benzer olabilir. Hastaların memnuniyetini etkileyen hastayla ilgili diğer değişkenler açısından daha kapsamlı çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Hasta memnuniyeti
• Rehabilitasyon
• Spinal kord yaralanması

DOES THE LEVEL AND SEVERITY OF INJURY AFFECT PATIENT SATISFACTION IN PATIENTS WITH CHRONIC SPINAL CORD INJURY UNDERGOING INPATIENT REHABILITATION ?

Öz

OBJECTIVE: This study aimed to investigate whether the level of satisfaction differed regarding the level and severity of injury in patients with chronic spinal cord injury (SCI) treated on an in-patient setting and whether patients with different satisfaction levels had distinct functional independence and health related quality of life (HRQoL) measures.
MATERIAL AND METHODS: The SCI level (cervical, thoracic, lumbosacral) of the patients was recorded, and the severity of SCI (incomplete,complete) was determined according to the American Spinal Cord Injury Association (ASIA) Impairment Scale. The degree of functional independence of the patients was determined using the Functional Independence Measure (FIM) motor score. HRQoL was assessed using the Short Form-36 (SF-36). Satisfaction was assessed using a questionnaire instituted to evaluate patient satisfaction. Satisfaction with the physician, nurse, physiotherapist, catering, cleaning service, technical equipment categories and the overall satisfaction were questioned and satisfaction levels were determined as ”very satisfied, satisfied, dissatisfied, very dissatisfied”.
RESULTS: 84 patients with chronic SCI were included in this cross-sectional study. Regarding the level of SCI, 19 patients had cervical (mean age:36.3±14.5, 78.9% male), 52 had thoracic (mean age: 32.1±13.6, 61.5% male), 13 had lumbosacral SCI (mean age: 38.8±20, 61.5% male). Regarding the severity of SCI, 36 patients had complete (mean age: 34±13, 77.7% male), 48 had incomplete (mean age: 35±15, 56.2% male) injury. There was no significant difference between cervical, thoracic and lumbosacral SCI groups in satisfaction categories. However, when the groups were compared in regard to the severity of SCI, patients with incomplete SCI had higher rates for satisfaction with the physician and technical equipment (p=0.03 and p=0.02, respectively). No significant difference was found in the other categories. Regarding the overall satisfaction, there was no significant difference in HRQoL and functional independence of the patients grouped according to their satisfaction levels.
CONCLUSIONS:Patients with incomplete SCI had higher satisfaction level with the physician and technical equipment. Although characteristics of injury are distinct, if the expectations are met similar satisfaction rates may be obtained in patients with chronic SCI. More comprehensive studies are needed in terms of other patient-related variables that affect patient satisfaction.

Anahtar Kelimeler

• Patient satisfaction
• Rehabilitation
• Spinal cord injury

Kaynakça

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